What is a Cesarean delivery?
Cesarean delivery is a surgical procedure in which the baby is delivered through incisions made in the abdomen and uterus. This operation is performed when vaginal delivery is not possible, not safe, or when the health of the mother or baby is at risk. There are two main types of incisions used, depending on the mother’s and baby’s condition:
Vertical incision: Extends from the navel to the pubic hairline.
Horizontal incision: Extends from side to side just above the pubic hairline. This is the most common type, as it heals better and causes less bleeding.
When is a Cesarean delivery performed?
Cesarean delivery is often performed in the following cases:
Cephalopelvic disproportion: The baby’s head or body is too large to pass safely through the pelvis, or the pelvis is too small to deliver a medium-sized baby.
Previous cesarean delivery: Although natural childbirth is possible after a previous cesarean delivery, this possibility is influenced by the type of uterine incision used in the previous surgery and the risk of uterine rupture.
Multiple pregnancies: Although natural childbirth is sometimes possible with twins, having two or more babies may require a cesarean delivery.
Placenta previa: The placenta is attached in a low location in the uterus, obstructing the baby’s passage through the cervix.
Transverse fetal position: The baby is in a horizontal or sideways position inside the uterus.
Breech position: The baby is in the womb with its feet or buttocks first. The doctor attempts to turn the baby’s position to allow for natural childbirth before resorting to cesarean delivery.
Labor not progressing: Also known as prolonged labor, this occurs when the cervix stops dilating or the baby stops descending in the birth canal.
Placental abruption: The placenta detaches from the uterine wall before the baby is delivered.
If the patient suffers from heart diseases that may worsen with labor during natural childbirth, or the presence of genital herpes during delivery.
If the patient has a large fibroid in the uterus, a pelvic fracture, or the baby suffers from certain congenital defects.
If the umbilical cord is wrapped around the baby’s neck or body, or stuck between the baby’s head and the pelvis.
Prolapsed umbilical cord, meaning it comes out of the cervix before the baby.
The baby may experience heart rate irregularities during labor, leading the doctor to decide on a cesarean delivery.
If there is sufficient time to plan the procedure, the midwife or your doctor will discuss and compare the benefits and risks of cesarean delivery and vaginal birth.
What are the types of Cesarean delivery?
Planned Cesarean Delivery:
A planned cesarean section is typically scheduled for the thirty-ninth week of pregnancy.
Possible reasons for conducting a planned cesarean section include:
Chronic diseases or infections in the mother.
Previous cesarean delivery.
Pregnancy with twins or more.
Cephalopelvic disproportion.
Unplanned Cesarean Delivery:
Unscheduled cesarean sections are surgeries where an attempt at natural childbirth is converted into a cesarean delivery after the mother is admitted to the hospital.
Possible reasons for an unplanned cesarean section include:
Lack of labor progress.
Weak contractions.
The baby is not tolerating labor.
Transverse or breech position of the baby at the onset of labor.
Emergency Cesarean: Done when the mother or baby is in immediate danger, such as
with cord prolapse
heavy bleeding
placental abruption
uterine rupture.
How is a cesarean delivery performed?
Anesthesia, in most planned cesarean operations, spinal anesthesia is used; however, in some cases, general anesthesia is used.
The abdomen is cleaned with an antiseptic, and an oxygen mask may be placed over the mouth and nose to increase oxygen flow to the baby.
The doctor places sterile drapes around the incision site and on the legs and chest.
The obstetrician then makes an incision in the skin and abdominal wall. The incision can be vertical or horizontal.
The doctor makes a 3 to 4-inch incision in the uterine wall.
The obstetrician removes the baby through these incisions, cuts the umbilical cord, removes the placenta, and closes the incisions with stitches or staples.
How to prepare for a cesarean delivery?
The specialist doctor usually asks the patient preparing for a cesarean delivery to do the following:
Sign a consent form granting permission for the procedure. “Read the form carefully and ask questions if something is unclear.”
Inquire about the last time you ate, and you will be asked not to eat or drink for 8 hours before the procedure.
If you have any allergies to medication or anesthesia.
Inform them of all medications (prescribed, over-the-counter), vitamins, herbs, and dietary supplements you are taking.
Inform them if you have a history of bleeding disorders or if you are taking any blood-thinning medications (anticoagulants), aspirin, or other drugs that affect blood coagulation. “You may be asked to stop these medications before the procedure.
You may be given medication to reduce stomach acid, which also helps dry secretions in the mouth and airways.
Follow any other instructions the doctor provides for preparation.
Recovery after Cesarean delivery:
Week 1:
Most women stay in the hospital for 2–4 days.
At home, rest, avoid lifting heavy objects, and keep the wound clean and dry.
Use pain relievers like acetaminophen or ibuprofen.
Vaginal bleeding is normal for 4–6 weeks and is heavier in the first few days.
Weeks 2–5:
Continue recovery steps from week 1.
Contact your doctor if you experience:
Severe pain.
Wound infection.
Unusual discharge.
Heavy bleeding.
Chest pain or shortness of breath.
Fever.
Leg pain or swelling.
Week 6:
You can resume normal activities unless your doctor advises otherwise.
Frequently Asked Questions:
How long does a Cesarean delivery take? Usually around 45 minutes, though in emergencies the baby may be delivered in as little as 15 minutes.
What are the risks of Cesarean delivery? Risks are slightly higher than vaginal birth and may include:
Infection.
Bleeding.
Blood clots.
Injury to the intestines or bladder.
Weakening of the uterine wall.
Anesthesia complications.
Fetal injury.
Can I have a vaginal birth after a Cesarean (VBAC)? Yes, if there are no contraindications. Your doctor will assess the risks and determine whether a VBAC is safe.
Can the placenta be donated after birth?
Yes, the placenta is rich in umbilical cord blood, which contains stem cells. These are immature cells capable of transforming into different types of cells. These stem cells are used to treat certain diseases like and are also utilized in medical research to develop new treatments.
